A spinal cord injury may be defined as damage to any part of the spinal cord or spinal nerves exiting the end of spinal canal which leads to permanent changes in the strength, sensation and body functions below the level of injury.
In most of the spinal cord injury cases, spinal cord remains intact as for spinal functions to be lost; spinal cord does not have to be completely severed.
Spinal Cord Injury Physical Therapy
There are generally four types of spinal cord injuries:
- Cord Maceration
- Cord Laceration
- Contusion Injury
- Solid Cord Injury
After spinal cord injury, the ability to control one’s limbs depends upon the site of injury along the spinal cord and the severity of injury to the spinal cord. The lowest normal part of the spinal cord is referred to as the neurological level of injury. Based on the severity of injury, spinal cord lesion can also be classified as:
- Complete Injury – If all the sensory and motor functions are lost below the spinal cord injury, the injury is called as complete.
- Incomplete injury – If some sensory or motor functions are present below the level of lesion, the injury is said to be incomplete. The degrees of incomplete injury are varying.
Additionally, paralysis caused due to spinal cord injury may be termed:
- Tetraplegia/Quadriplegia – There is affection of arms, hands, trunk, legs and pelvic organs due to spinal cord injury.
- Paraplegia – Paralysis affects parts of trunk, pelvic organs and legs after spinal cord injury.
Grading scale for evaluation of functional recovery – Frenkel scale is the most commonly used grading system for evaluation of functional recovery of spinal cord injury. Based on motor and sensory deficits, the scale contains five grades (A – E)
A – Complete paralysis
B – Sensory function is present only below the level of injury
C – Incomplete motor function below the level of injury
D – Fair to good motor function below the level of injury
E – Normal function
Some of the most common causes of spinal cord injuries include:
- Motor – vehicle accidents
- Sports and recreation injuries like athletics
- Acts of violence including gunshot and knife wounds
- Alcohol use
- Diseases like cancer, arthritis, inflammation of spinal cord may cause spinal cord injuries
The symptoms of spinal cord injury vary depending upon the site and severity of the injury. For example, if there is damage to nerves below the C3 level of nerves, there would be loss of sensation and paralysis of arms, upper body and legs. There could be damage to a person’s chest muscles which may make his breathing difficult.
Some of the common signs and symptoms of spinal cord injury include:
- Loss of movement
- Loss of sensation including loss of feeling of touch, heat or cold
- Loss of bladder or bowel control
- Increased reflex activities or spasms
- Altered sexual function, sexual sensitivity and fertility
- Pain or a stinging sensation
- Difficulty breathing, coughing and clearing lung secretions
Emergency signs and symptoms after a spinal cord injury may include:
- Extreme pain in the back or pressure in head, neck or back
- Weakness or paralysis in any part of the body
- Loss of bladder or bowel control
- Numbness or tingling sensation in hands or feet
- Difficulty walking and balancing
- Difficulty breathing
Some of the emergency diagnostic tests for spinal cord injury may include X-rays, CT scan and MRI of the spine. After a few days of injury, when swelling subsides, neurological examination is done to determine the level and completeness of injury which involves assessing muscle strength, sensitivity to light touch and pinprick.
Immediate medical intervention at the time of injury aims at stabilizing the spine and providing aggressive treatment with corticosteroid drugs so as to limit damage and improve chances of recovery. Surgery may also be done to stabilize spine which can involve fusion of vertebrae together or removing bone chips/bullets or other objects for relieving pressure from the spine. One may require traction and bed rest to immobilize back so that it may heal. Other treatments may involve catheterization if bladder control is lost, antibiotics for UTI, frequent changes in positioning to prevent bedsores, skin care and physical therapy.
Long – Term treatment – Long term treatment for Spinal cord injuries involves intense rehabilitation therapy since disability that remains after a period of six months of injury is likely to be permanent. Rehabilitation, if not a cure for disability, can help an individual maximize the level of function and can help him lead an independent life. Continuing treatment after spinal cord injury may involve physical and occupational therapy, psychological counseling, use of mechanical and electrical devices and monitoring by physicians.
Spinal cord injury rehabilitation is needed to optimize recovery and if necessary, help people adapt to a new way of life after the injury. At ORC, our rehabilitation team constantly endeavors to meet ongoing requirements of an individual after spinal cord injury which includes improving the person’s physical and mental functioning, providing emotional support and helping him to get back to his community as soon as possible.
ORC is the most trusted provider of rehabilitation services in India in association with best rehabilitation experts. Being the pioneering medical tourism company in India, ORC has helped numerous of clients from across the world avail quality and affordable medical treatment in India.
Our team of chosen few rehabilitation experts provide customized treatment to patients as per their abilities and demands. The goal directed approach of rehabilitation enables patients to:
- Improve mobility and physical function
- Develop skills for performing daily living activities
- Facilitate activities at home, work or community by utilizing adaptive technologies
- Overcome psycho-social barriers that may interfere with adjustment to life ahead.
Our Spinal cord injury rehabilitation programs are designed in such a manner that they help SCI patients realize their physical, social and emotional potentials to the maximum levels. Our interdisciplinary team of rehabilitation experts includes physical, occupational and speech and language therapists who make individualized treatment plan and provide a holistic rehabilitation. Together the team assesses the patient progress and treatment goals and developed and adjusted accordingly.
At ORC associated clinics, we use Combination Therapy which uses an array of therapies for paralytic patients. Combination Therapy uses sophisticated electronic equipment called Mentamove which in conjunction with best treatment approaches makes rehabilitation for paralysed patients highly effective. The principal of “Neuro-plasticity” i.e – ability of brain to reorganize its neuronal network so that it functions by experience based on which Combination Therapy helps patients relearn and adapt to the new conditions.
We aim at providing comprehensive rehabilitation services tailored to each patient’s needs, abilities and goals. The main goals of our rehabilitation programs aim to help patients in following areas:
- Managing spasticity
- Restoring upper extremity function
- Providing locomotor training
- Helping with diaphragm pacing system
- Educating about seating and positioning in the wheel chair
- Bladder and bowel management
- Providing self-care skills
- Providing pre-vocational skills
- Providing sexuality and fertility management, education and counseling
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